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US · guidance

CMS Pub. 100-04, ch. 1, § 30.1.3

Provider Treatment of Beneficiaries

activein force · 2026-08-25 – presentas-observed

In the agreement between CMS and a provider, the provider agrees to accept Medicare

beneficiaries for care and treatment. The provider cannot impose any limitations with

respect to care and treatment of Medicare beneficiaries that it does not also impose on all

other persons seeking care and treatment. If the provider does not furnish treatment for

certain illnesses and conditions to patients who are not Medicare beneficiaries, it need not

furnish such treatment to Medicare beneficiaries in order to participate in the Medicare

program. It may not, however, refuse to furnish treatment for certain illnesses or

conditions to Medicare beneficiaries if it furnishes such treatment to others. Failure to

abide by this rule is a cause for termination of the provider’s agreement to participate in

the Medicare program (see the regulations at 42 CFR 489.53(a)(2), and also see Pub.

100-01, Medicare General Information, Eligibility, and Entitlement Manual, chapter 5,

§10.2).

History

(Rev.4163, Issued: 11-02-18, Effective: 12-04-18, Implementation: 12-04-18)

Provenance

Source
cms.gov
Retrieved
2026-08-25
Edition
iom-2026-08-25
Content hash
745966205d03eb0ee62f2efc68494b13282402c8955f442ac6d3d1f66a2eb2b4
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